title: Controlateral cavernous syndrome, brainstem congestion and posterior fossa venous thrombosis with cerebellar hematoma related to a ruptured intracavernous carotid artery aneurysm.
abstract: Intracavernous carotid artery aneurysms (ICCAs) are rarely associated with life-threatening complications. We describe a 55-year-old woman who, after the rupture of an intracavernous carotid artery aneurysm, presented with a contralateral cavernous sinus syndrome and severe posterior fossa and spinal cord symptoms. Following parent artery occlusion, thrombosis of the posterior fossa and spinal cord veins caused a progressive worsening of the neurological status to a "locked-in" state. The patient fully recovered with anticoagulation therapy. Comprehension of the pathophysiological mechanism associated with the rupture of ICCA and early diagnosis of the related symptoms are essential in order to plan a correct treatment that includes the management of the aneurysm rupture and of possible complications related to venous thrombosis.
authors.affiliation: Department of Neurosurgery, Hopital Foch, Suresnes, France. s.aldea@hopital-foch.org
authors.forename: Sorin
authors.initials: S
authors.lastname: Aldea
authors.forename: Pierre
authors.initials: P
authors.lastname: Guedin
authors.forename: Luca
authors.initials: L
authors.lastname: Roccatagliata
authors.forename: Anne
authors.initials: A
authors.lastname: Boulin
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Auliac
authors.forename: Michel
authors.initials: M
authors.lastname: Dupuy
authors.forename: Charles
authors.initials: C
authors.lastname: Cerf
authors.forename: Stéphan
authors.initials: S
authors.lastname: Gaillard
authors.forename: Georges
authors.initials: G
authors.lastname: Rodesch
mesh_terms: D020434:Abducens Nerve Diseases / Q000175:diagnosis*; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000628:therapy; D001929:Brain Edema / Q000175:diagnosis*; D001933:Brain Stem / Q000098:blood supply*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000628:therapy; D002343:Carotid Artery, Internal; D020216:Carotid-Cavernous Sinus Fistula / Q000175:diagnosis*; D002526:Cerebellar Diseases / Q000175:diagnosis*; D002533:Cerebral Angiography; D003097:Collateral Circulation / Q000502:physiology; D003388:Cranial Fossa, Posterior / Q000098:blood supply*; D004621:Embolization, Therapeutic; D005094:Exophthalmos / Q000175:diagnosis; D005260:Female; D006406:Hematoma / Q000175:diagnosis*; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis*; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000175:diagnosis*